Introduction Systemic lupus erythematosus (SLE) is an autoimmune disease with wild spectrum of manifestations. Disease severity and outcome are variable in different ethnic groups. The aim of this study was to describe clinical, biological and immunological features of SLE in a Tunisian cohort.
Objectives A retrospective study, including patients with SLE (Revised criteria of the American College of Rheumatology), followed in a department of Internal Medicine from 2004 to 2017. Demographic, clinical, biological and immunological characteristics of patients were recorded and analysed. Treatment and outcome were described.
Results medical records of 89 patients were analysed. Their mean age at the disease onset was 35.2 years±13 years (14 to 72 years). F/M sex ratio was 8/1. Familiar history of SLE or another auto immune disease was recorded in 5.6% and 10.1% of patients respectively. Clinical manifestations were as following: cutaneous involvement in 88.8%, pulmonary manifestations in 23.6%, cardiovascular involvement in 43.8%, renal involvement in 29.2%, articular manifestations in 69.7% neurological and psychiatric manifestations in 20.2% and 6.7% respectively. Associated auto immune diseases were Sjogren syndrome in 14.6%, rheumatoid arthritis in 6.7% and thyroiditis in 7.8%. Biological findings showed leucopenia in 48.8%, thrombopenia in 26.2% and hemolytic auto immune anaemia in 3.6%. Immunological screening revealed positive anti nuclear antibodies in 92.1%, anti DNA antibodies in 84.3%, anti Sm, anti nucleosome and anti phospholipid antibodies in 40.8%, 31.6% and 36.6% respectively. SLE activity was assessed by SLEDAI score which mean value was 9.1. Relapses occurred in 39.3% of the patients and remission was recorded in 56%. Four patients died. Infection occurred in 18.8% of the cases, steroid induced diabetes in 12.9% and osteoporosis in 16.5%.
Conclusions In our series, SLE patients had a high prevalence of cutaneous and articular manifestations. Nephritis lupus prevalence was similar to other African, Afro-american and Hispanic groups and lower than Asians. Global outcome was good with more than a half remission.
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